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Dissertation on Diabetes for BSC Nursing



             In addition, Yuen et al. (2010) demonstrated the limitation of diet or physical activity alone, they suggested an intensive intervention that will include monitored physical exercise (150 minutes per week) in addition to Mediterranean diet (foods rich in olive oil, vegetables and fruits, including pulses and nuts, whole grains and low-fat dairy) or prudent diet (high intake of plant-based foods, and a lower intake of red meat, meat products, sweets, high-fat dairy and refined grains), moderate consumption of alcohol and smoking cessation to be more effective (Clark, 2014, and Dunkley, 2014). However, Salas-Salvado ́ et al. (2011) argued that there is no group of diet that is universally accepted, but suggested that the individual preference should be considered in planning daily nutrition to improve adherence.
             However, Walker et al. (2010) and Yamaoka &Tango; (2005) demonstrate in a survey that 70% of study participants who achieved a healthier Body mass index (BMI) in a lifestyle intervention study started to gain weight in just six months after the study. In addition, they showed that dropout rate reduced when behavioral change strategy is incorporated in studies. Therefore, several studies recommendations have been emphasizing on a more sustainable intervention which individuals can successfully adhere to for a longer period or through their life time to maintain the healthier state established in this programs. However, substantial challenges still exist concerning evidenced-based strategies that will sustain these behavioral changes. Consequently, this review will address the gap of these intensive and restrictively unaffordable interventions used in trials which should be converted into a practically affordable and sustainable intervention that assures adherence in the real-world which nonetheless, preserves some degree of effectiveness (Law et al., 2012, and Lindstro ̈m et al.


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